Individual
MISS SHAKAYA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
24 SPINDLE HILL RD, WELLMORE INC VALLIANT HOUSE, WOLCOTT, CT 06716-1722
(203) 879-5533
(203) 879-5537
Mailing address
141 E MAIN ST, 4TH FLR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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